联合应用白三烯受体拮抗剂治疗小儿变应性 鼻炎的临床观察

Clinical effect of combined application of leukotriene receptor antagonists on allergic rhinitis in children

摘要:

目的探讨联合应用白三烯受体拮抗剂治疗小儿中、重度变应性鼻炎(allergic rhinitis, AR)的临床疗效。方法随机将62例中、重度AR患儿分为常规治疗组和联合治疗组,每组患者各31例，常规治疗组用第二代抗组胺药口服、鼻用糖皮质激素喷鼻治疗；联合治疗组在常规治疗组的基础上加用孟鲁司特钠咀嚼片口服,两组患者疗程均为4周。对两组患儿在治疗前、治疗4周结束时及治疗结束后3个月鼻部症状视觉模拟量表(VAS)评分及总有效率进行比较。 结果①鼻部症状VAS评分每组患者治疗前与治疗4周结束时、治疗结束后3个月分别比较差异均具有统计学意义(P均<0.05)；治疗4周结束时、治疗结束后3个月，联合治疗组和常规治疗组分别比较,差异均有统计学意义(P均<0.05)；②总有效率:治疗4周结束时、治疗结束后3个月，联合治疗组（总有效率为96.67%、90.00%）和常规治疗组（总有效率83.33%、73.33%）分别比较,差异均有统计学意义(P均<0.05)；常规治疗组治疗4周结束时和治疗结束后3个月总有效率比较，差异具有统计学意义(P<0.05)，而联合治疗组差异则无统计学意义 (P>0.05)。结论白三烯受体拮抗剂联合鼻用糖皮质激素和第二代抗组胺药治疗小儿中、重度AR可以增强和巩固疗效。

关键词:鼻炎|变应性|白三烯受体拮抗剂|抗组胺药|治疗结果

Abstract:

ObjectiveTo investigate the clinical effect of combined use of leukotriene receptor antagonist in children with moderate to severe allergic rhinitis (AR).Methods62 patients with moderate to severe AR were randomly divided into conventional treatment group and combined treatment group (31 cases in each group). The patients in the routine treatment group received oral administration of secondgeneration antihistamines and corticosteroid nasal spray, while those in the combined treatment group were given, on the basis of the routine treatment, Montelukast sodium chewable tablets. The treatment courses of both groups were 4 weeks. Visual analogue scale (VAS) scores and total effective rates were compared between the two groups at the timepoints before treatment, at the end of treatment and at 3 months after treatment.Results①Compared with VAS scores before treatment, the scores at the end of treatment and 3 months after treatment were significantly reduced in both groups (all P<0.05). The differences of scores between the combined treatment group and routine treatment group at the end of treatment and 3 months after treatment were statistically significant respectively (both P<0.05). ②The differences of total effective rates between the combined treatment group and routine treatment group at the end of treatment and 3 months after treatment were statistically significant respectively (both P<0.05). In addition, the difference between the total effective rate at the end of treatment and 3 months after treatment in the conventional treatment group was statistically significant (P<0.05), while this in the combined treatment group was insignificant (P>0.05).ConclusionLeukotriene receptor antagonists combined with nasal corticosteroids and secondgeneration antihistamines can enhance and consolidate the therapeutic effect in the treatment of moderate to severe AR in children.

Key words:Rhinitis|allergic| Leukotriene receptor antagonist|Antihistamine|Treatment outcome